NEUROLOGIC CONDITIONS: A wide variety of neurological conditions may affect driving safety.  A partial list includes:

1. 1. Strokes
   2. Head Injuries
   3. Cerebral Palsy
   4. Multiple Sclerosis
   5. Progressive conditions such as muscular atrophies and dystrophies, myasthenia gravis, and various spinal cord and brain diseases
   6. Seizures and other episodic conditions are considered as a separate category - see Category E (Seizures and other Episodic Conditions)
   7. Chronic or frequent severe vertigo (subjective sense of movement or self or environment, usually spinning)

The common element in all of these is the disturbance of sensory, motor or coordinating functions sufficient to affect driving.  Some of them will be considered as stable conditions for which a driving test showing adequate performance in the type of vehicle to be driven will be sufficient.  However, other conditions that have not yet stabilized or have a probability of progression or need for medication may require a medical report initially or at intervals.  The usual interval for reconfirmation is as shown, or may be increased up to the time interval since the last significant change in status.

Persons with neurological disorders may also have orthopedic or other problems and should also be given a safety assessment level as appropriate under Category J, (Musculoskeletal) in relation to driving.  The health care professional should indicate by checking the appropriate box on the Functional Ability Evaluation Medical Report form if a driving skills test should be given.

In some neurological disorders, there may be other problems which impair driving.  For example, a head injury may not only result in paralysis, but in visual field loss and impairment of learning and memory.  These should be shown as safety assessment levels in the other appropriate categories as well.  In evaluating late effects of head injuries, careful inquiry into the duration of coma or amnesia will be found helpful in evaluating the likelihood of a persisting effect which may impair reaction time and thus be important in considering limitations on driving speeds.  Similar considerations may apply in the use of a variety of medications which affect neuro-motor and cognitive functions.

COMMERCIAL INTRASTATE DRIVERS: Drivers given a Safety Assessment Level of 4 may or may not be successful in passing a driving skills test, but should have an opportunity to do so if their conditions are stable.  The health care professional should check the driving skills test box at the bottom of the form.